Healthcare Provider Details

I. General information

NPI: 1679426027
Provider Name (Legal Business Name): SHELLY LYNN COHN FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2744 GULF BREEZE PKWY STE 150
GULF BREEZE FL
32563-3091
US

IV. Provider business mailing address

6807 STONEHENGE CIR
PENSACOLA FL
32506-3957
US

V. Phone/Fax

Practice location:
  • Phone: 551-295-8223
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1045252
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: